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[Bronchiolitis caused by graft versus host reaction after bone marrow allograft]
D Piperno1, M Vincent, T Wiesendanger
1Département de Pneumologie, Hôpital Louis-Pradel, Lyon.
Revue Des Maladies Respiratoires
|January 1, 1987
Summary
Graft versus host disease (GVHD) can cause severe lung complications after marrow transplants. This case highlights lethal obstructive respiratory failure due to small airway disease, emphasizing the need for early recognition and management.
Area of Science:
- Hematology
- Immunology
- Pulmonology
Background:
- Graft-versus-host (GVH) reactions are a significant complication following allogeneic marrow transplantation.
- Pulmonary complications, including bronchiolitis leading to respiratory failure, are recognized manifestations of GVH disease.
Observation:
- An 18-year-old male developed lethal obstructive respiratory failure 2.5 years post-marrow graft for acute lymphoblastic leukemia.
- Pulmonary function tests revealed obstructive respiratory failure characteristic of small airway disease, with elevated resistances and abnormal compliance at high frequencies.
Findings:
- The patient presented with hypoxia, hypercapnia, and specific lung function abnormalities indicative of small airway disease.
- The initial pulmonary signs appeared after an influenza infection, suggesting a potential role for infections in GVH pathogenesis.
Implications:
- This case underscores the severe and potentially fatal pulmonary sequelae of GVH disease, specifically small airway obstruction.
- Understanding the role of infections and iatrogenic factors in GVH pathogenesis is crucial for improving patient outcomes after marrow transplantation.